Eternity'S Path

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

NV20131272872 Issued in NV

Legal business name

ETERNITY'S PATH

Practice address

1345 N Hollywood Blvd
Las Vegas, NV 89110-2021

Phone

(702) 758-5961

NPI assigned

May 10, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Sarita Edwards

Title

President

Phone

(702) 540-8296

Specialties & licenses 5

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Monteal Martin

  • Community/Behavioral Health Agency
  • North Las Vegas, NV
  • NPI 1306269634
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375920000000",
    "number": "1609212182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5546 CAMINO AL NORTE # 2-333",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890310805",
            "telephone_number": "702-540-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 N HOLLYWOOD BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891102021",
            "telephone_number": "702-758-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETERNITY'S PATH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-10",
        "last_updated": "2013-08-08",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "SARITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-540-8296",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "NV",
            "license": "NV20131272872",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "NV20131272872",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NV",
            "license": "NV20131272872",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "NV",
            "license": "NV20131272872",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NV",
            "license": "NV20131272872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eterna Medical Group LLC
• Eternal Hospice
• Eterne Wellness LLC
• Eternity Care Services, Inc
• Eternity of Love
• Eternitys Peak
• Damian Etheredge
• Alexis Etheridge
• Samantha Etheridge
• Whitney Blair Etheridge

• Community/Behavioral Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.